Today
Fri 4 December 2020

Byline Times’ chief medical officer John Ashton looks at the tragic consequences of a lack of transparency – the first rule of public health

Boris Johnson’s chaotic announcement of a second lockdown has brought into sharp relief the shambolic response of the Government, seen from the very beginning of this pandemic.

Whether it is now possible to regain control of the Coronavirus without destroying the economy for a generation remains to be seen, but having squandered the breathing space created by the first lockdown, the omens are not good.

At the heart of this dire situation is the neglect of the local and regional public health system over the past 10 years, coupled with a pathetic lack of leadership shown by the narcissistic Prime Minister. Among the many character defects of Johnson, it is perhaps his capacity for magical thinking, combined with his tendency to delegate responsibility and blame, that is most toxic in a national emergency.


The Trump Playbook

It is clear from a plethora of pandemic planning documents and the practical experiences of public health professionals that openness and transparency are prerequisites for maintaining the trust of the public during a national event such as this.

Yet, as in war, truth has been the first casualty of the Coronavirus pandemic.

Fresh from his General Election victory in December, and intent on pushing through Brexit on 31 January, Johnson was unable to shift style from a campaigner to a statesman when the time demanded it.

Fuelled by a Trumpian culture war against the so-called ‘liberal elite’, Johnson’s initial approach to communications involved a vendetta against the mainstream media in general and the BBC and Radio 4’s Today programme in particular.

By the end of February, when the need for good communications dawned on Johnson and his chief aide Dominic Cummings, they instinctively reached for the political messengers that had brought them past victories – the digital communications company Topham Guerin and Australian conservative spin-master Isaac Levido.

The result was superficial slogans, rapid changes of subject, dead cats, sleights of hand and diversionary tactics, drawing headlines away from the public health realities and Johnson’s failures.


Collateral Damage

Throughout the pandemic, the public has been caught in a wellspring of misinformation about personal protective equipment (PPE), the UK’s testing system, and the plan for exiting this chaos.

Millions of pounds of public money was squandered on Nightingale hospitals that were never used because they could not be staffed and then later billions of pounds more were thrown, without due process, at private companies with little or no experience of supplying PPE, or of implementing successful testing and contact tracing systems.

Infected patients were discharged from hospitals to care homes, igniting the epidemic and costing the lives of hundreds of NHS staff – many of them from black and ethnic minority communities. We still have no realistic measure of how many prison officers or prisoners have died from COVID-19, nor how many people have died at home from the disease. They are merely considered collateral damage.

In a country with a proud tradition of public health, dating back to the 19th Century, we have been let down by an over-centralised, dysfunctional system. This has been compounded by the erosion of local teams, along with their expertise in contact tracing – the very foundation of public health intervention.


A False Dichotomy

But it is the Government’s misuse of data that is arguably most concerning.

During March, the public was initially only notified of confirmed COVID-19 deaths occurring in hospitals. It took the Economist magazine to expose the inaccuracies caused by this system – revealing that the true total could be twice as high, even before deaths at home were taken into account.

Later, the arbitrary decision was taken to redact 5,000 COVID-19 deaths from the total, on the spurious grounds that they occurred at least 28 days after the time of infection. All the while, these manoeuvres played down the true toll of the pandemic and were met with the acquiescence of Government advisors.

This manipulation of the data can now be seen as the battle to control the political narrative of the crisis, to the benefit of the free market ideology so prevalent among the ruling administration. This narrative sees public health measures as being in opposition to a dynamic economy, when all the lessons from abroad teach us that public health measures and economic security go hand in glove.

In China, Hong Kong, Taiwan, South Korea, New Zealand and elsewhere – including the Isle of Man, Ceredigion in mid-Wales, Groningen in the Netherlands, and Cuba – decisive action rooted in the community has enabled life to go on and economies to rebound.

As the Government continues to vacillate, unsure whether public health or the economy is the main concern, lacking the imagination to come up with a vision of how to sail with the storm towards a safe destination, the victim count mounts.

A generation of schoolchildren and students face a blighted future, distrust is rampant and civil disturbance beckons. It seems as if the latest distraction is a focus on ‘Christmas as usual’, when the priority has to be retrieving trust and community solidarity.

The stark fact is that the Government has failed us all. The only option now is for families and communities, working with their community institutions and local government, to take back control from a failed administration.

We had a glimpse of what is possible during the Spring, when tens of thousands of community groups spontaneously organised to help each other. That was a rehearsal for what must happen now. It remains to be seen whether the Government of Boris Johnson will be a participant or an observer.

John Ashton is the author of ‘Blinded by Corona: How The Pandemic Ruined Britain’s Health And Wealth’


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